轻中度哮喘患者与健康人的运动耐量对比研究

A comparative study on exercise tolerance between mild to moderate asthmatic patients and healthy volunteers

目的 :比较轻中度哮喘患者与健康人的运动心肺功能 ,研究运动对哮喘患者肺功能的影响 ,探讨轻中度哮喘患者提高运动耐量的可行性。方法 :采用负荷递增运动方案 ,对 2 0例轻中度哮喘患者及 2 0例健康志愿者进行了运动心肺功能试验。运动前后测一秒钟用力呼气容积 (FEV1 )、用力肺活量 (FVC)、最大呼气中段流量 (FEF 2 5 %- 75 % )、最大呼气末段流量 (FEF 75 % - 85 % )、呼气流量峰值 (PEF)等 ,运动中监测心率 (HR)、每分钟氧耗量(VO2 )、每分钟二氧化碳排出量 (VCO2 )、每分钟通气量 (VE)、氧脉搏 (O2 pulse)、呼吸频率 (BF)等。结果 :运动后 ,哮喘组与正常对照组的FVC、FEV1 、PEF、FEF 2 5 %— 75 %、FEF 75 %— 85 %均有所改善 ,有统计学意义 (P <0 .0 5) ,但两组在改善的差值上无显著意义 (P >0 .0 5)。哮喘患者的最大作功、最大氧耗量 (VO2max)、最大二氧化碳排出量 (VCO2max)、最大每分钟通气量 (VEmax)均显著低于健康人 (P <0 .0 5) ,无氧阈提前出现。结论 :轻中度哮喘患者的运动能力低于健康人 。

Objective: To study the effect of exercise on pulmonary function of patients with asthma, and to assess the practicability of increasing exercise tolerance and improving life quality in the patients. Method: 20 mild to moderate asthmatic patients were submitted to cardiopulmonary exercise testing with 20 healthy volunteers as controls. The other incremental tests such as FEV 1, FVC, FEF 25%-75%, FEF 75%-85% and PEF were measured before and after exercise. HR, VO 2, VCO 2, VE, O 2-pulse and BF were continuously measured during the test. Result:After exercise, FEV 1, FVC, FEF 25%-75%, FEF 75%-85% and PEF were improved obviously in the two groups ( P <0.05),but there was no distinguishing in the improvement difference ( P >0.05).The maximal work, the maximal volume of oxygen uptake(VO 2max ), the maximal volume of carbon dioxide(VCO 2max ),and the maximal minute ventilation volume(VE max ) in the asthmatic patients were significantly decreased ( P <0.05),and anaerobic threshold(AT) appeared earlier. Conclusion:The exercise capacity in mild to moderate asthmatic patients is lower than the healthy control, but by low load exercise, asthmatic patients may receive the similar pulmonary function improvement as the healthy control. Author′s address Dept. of Respiratory Medicine, The Second Hospital Affiliated to Harbin Medical University, 150086